Impact of Severe Tricuspid Regurgitation on Long Term Survival

Abstract

Background:Tricuspid regurgitation (TR) is a common echocardiographic finding, which often accompanies left sided valve disease. Data on mortality and morbidity in patients with severe TR are limited.Objectives:We sought to assess the outcome of patients with severe TR with the hypothesis that significant TR adversely impacts quality of life and survival, independent of pulmonary artery pressure (PAP) and left ventricular ejection fraction (LVEF).Materials and Methods:Between 2002 and 2012, 358 consecutive patients (mean age of 54.67± 13.25years, 75.5% female) with severe TR based on history and transthoracic echocardiography (TTE) were enrolled. Patients with severe left sided valvular heart disease and congenital heart disease were excluded. The prevalence of heart failure symptoms, rehospitalization, and duration of hospitalization were evaluated. Survival was calculated according Kaplan Meier curve analysis.Results:Heart failure (50%) was the most cause of death. Mean years of survival from diagnosis of severe TR was 4.35±3.66, and mean years of survival from onset of symptom was 2.28±1.40. Ninety cases (25.1%) were admitted due to heart failure and through mean of 1.9±0.8 year- follow up (6-32month), 14% of all patients and 36.8% of patients with right heart failure rehospitalized. Atrial fibrillation was reported in 70.5% of patients.Conclusions:There is a significant increased incidence of mortality, prolonged hospitalization, and rehospitalization in symptomatic patients with severe TR. Therefore, we recommend more aggressive approach toward TV repair or replacement in these patients regardless of PAP and systolic function.

Tricuspid Regurgitation – Medical Management and Evolving Interventional Concepts

“…Several more recent studies confirmed these results and therefore underlined the correlation between severity of TR and increased mortality ( 25–29 ). In addition, patients with severe symptomatic TR showed prolonged hospitalization and a higher rate of rehospitalization ( 26 ).…”

Association of spectral Doppler cardiac activity in the lower limb veins and echocardiographic findings in patients with tricuspid regurgitation

“…Patients affected by tricuspid regurgitation present with the following symptoms: fatigue, atrial fibrillation, discomfort especially in the neck region, ascites, liver and renal dysfunction, abdominal discomfort and pain, sleeplessness, swelling in the lower limbs, cardiac activities in the veins of the lower limbs, pleural or cardiac effusion, shortness of breath, and cold skin. These symptoms are most commonly associated with severe heart disease ( 3 ) . The diagnosis of tricuspid valve disease can be facilitated by using electrocardiogram (ECG), Doppler echocardiography, magnetic resonance imaging (MRI), radionuclide scan, chest X-ray, transesophageal echocardiography, and cardiac catheterization ( 4 ) .…”

Tricuspid valve regurgitation decreases after mitraclip implantation: Fluid structure interaction simulation

“…There are approximately 1.6 million patients with TR in the US alone [1][2][3]. Higher risk of mortality and morbidity, and higher rates of hospitalization are reported as consequences of severe TR if untreated [4][5][6][7].…”